In short

J1322 is the HCPCS Level II code for injection, elosulfase alfa, 1 mg. CMS assigns NDCs for Vimizim to it. One billing unit is 1 mg. The Medicare Part B payment limit is $320.781 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file
HCPCS codeJ1322
Billing unit1 mg
Descriptor
Injection, elosulfase alfa, 1 mg
Short descriptor
Elosulfase alfa, injection
Code set
HCPCS Level II, maintained by CMS
Effective
Jan 1, 2015

The billing unit is read from the descriptor. Confirm it against the CMS file before billing.

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$320.781
Per1 mg
Coinsurance19.853%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. CMS note: Inflation-adjusted coinsurance. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files

Units and claim line

Units = dose given ÷ 1 mg. For example, 100 mg is 100 units. Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

Enter the dose given to build the claim line.

NDCs billed under J1322

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 1 NDC to J1322 for Vimizim. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J1322 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Vimizim68135-0100-01BioMarin Pharmaceutical Inc.55

J1322: common questions

Is J1322 a CPT code?
No. J1322 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
What NDCs are billed under J1322?
CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 1 NDC under J1322, for Vimizim. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J1322?
$320.781 per 1 mg, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.
What is one billing unit of J1322?
One unit of J1322 is 1 mg, as stated in the code's descriptor. Units to report = dose given ÷ 1 mg. J-code billing units.

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